The safer choices project: methodological issues in school-based health promotion intervention research.
Randomized trials of school-based health promotion programs present unique design and analytical issues not widely discussed in the research literature. This article describes the Safer Choices study--a school-based program for prevention of HIV, other sexually transmitted diseases, and pregnancy--to illustrate critical methodological issues involved in large-scale, school-based intervention trials, particularly those evaluating interventions with a school-wide focus. The issues presented are: 1) comparability of the intervention and control groups even when few units are randomized; 2) factors that affect the decision to use a cohort or cross-sectional design; and 3) appropriate analysis strategy when the unit of randomization and intervention is at the school level, but observations are at the student level.
Basen-Engquist
K
K
Dept. of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Parcel
G S
GS
Harrist
R
R
Kirby
D
D
Coyle
K
K
Banspach
S
S
Rugg
D
D
D000293:Adolescent; D002140:California; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012574:Schools; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D013781:Texas